Regional anesthesia
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Regional anesthesia · Jul 1994
Randomized Controlled Trial Comparative Study Clinical TrialSubarachnoid labor analgesia. Fentanyl and morphine versus sufentanil and morphine.
To compare the duration of pain relief and incidence of side effects using two subarachnoid administered drug combinations for labor analgesia: fentanyl 25 micrograms with morphine 0.25 mg or sufentanil 10 micrograms with morphine 0.25 mg. ⋯ Both fentanyl and morphine and sufentanil and morphine provide adequate labor analgesia for about 2 hours. Patients who receive sufentanil experience more severe pruritus.
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Regional anesthesia · Jul 1994
Comparative Study Clinical TrialSurvey of opioid use in chronic nonmalignant pain patients.
Opioids have been accepted as appropriate treatment for acute and cancer pain, but remain controversial for use with chronic nonmalignant pain. Clinicians are concerned about efficacy, tolerance, addiction, and unwanted side effects. ⋯ The results suggest that chronic nonmalignant pain patients taking opioids for their pain reported some tolerance, fear of addiction, and side effects when taking opioids. However, despite these concerns, some of these patients felt that opioid therapy was very beneficial. Further investigations are needed to determine which patient characteristics predict benefit from opioid therapy for nonmalignant pain.
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Regional anesthesia · Jul 1994
Clinical TrialInfluence of the subarachnoid position of microcatheters on onset of analgesia and dose of plain bupivacaine 0.5% in continuous spinal anesthesia.
Many factors have an impact on the outcome of continuous spinal anesthesia (CSA) with small-bore catheters. Recent publications of neurologic complications after CSA suggest that the local anesthetic as well as the microspinal catheter influence the analgesic effect in CSA. This prospective study was designed to evaluate the influence of the subarachnoid position of 28-gauge spinal catheters on the speed of onset of analgesia and on the dose of plain bupivacaine 0.5% required for a block at the level of T-10 in CSA. ⋯ The subarachnoid position of a 28-gauge microcatheter is an important factor with regard to the effectiveness (e.g., onset time of analgesia and dose requirement) of CSA using plain bupivacaine 0.5%.
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Regional anesthesia · Jul 1994
Clinical TrialSubarachnoid microcatheter anesthesia in small children.
Standard single dose spinal anesthesia is a recognized technique for neonates and small children. The advent of the subarachnoid microcatheter technique potentially expands the use of spinal anesthesia. The authors studied the use of repeated neuroblock via spinal catheters in 10 children under 5 years, undergoing major abdominal surgery of 2 hours or longer. ⋯ The technique was a very effective method of providing adjunct operative anesthesia in infants and small children. Analgesia, muscle relaxation, and cardiovascular stability were present and no complications arose besides the apparent cerebrospinal fluid leak. The resultant risk of infection or possible duracutaneous fistula formation contraindicates the use of subarachnoid catheters of 28 gauge for postoperative analgesic use in young children.
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Regional anesthesia · Jul 1994
Clinical TrialOne needle transcrural celiac plexus block. Single shot or continuous technique, or both.
The purpose of the study was to establish a one needle transcrural technique for the celiac plexus block in the lateral position. Contrary to the conventional prone bilateral approach, the lateral position with a cushion under the flank is better tolerated and makes bony landmarks more accessible. Unilateral needle placement reduces the morbidity of the technique and should also enable one to apply single administration or continuous blocks, or both. ⋯ Clinical results proved that the unilateral, transcrural technique in a lateral position is simple, safe, and gives a reliable celiac plexus block or neurolysis effects under fluoroscopy, or both, comparable to the results where computed tomography was used. The possibility of continuous block makes this technique useful in clinical practice.